Study participants Infants were recruited in five neonatal intensive care units in northwest North CArolina. These were the only sites providing neonatal intensive care in a twenty-county region in northwest North Carolina. Infants were born between March 1996 and September 1999. Infants were eligible for the study if they were born before 33 weeks gestational age, required supplemental oxygen at 36 weeks gestational age, and were discharged home after neonatal intensive care. Neonates who had major congenital anomalies and/ or had tracheostomy tubes were excluded. Also excluded were families in which the mother did not speak English, because the intervention depended on verbal communication with the nurse specialist, and families who lived more than 150 miles from our clinic because such families typically are referred to regional neonatal center closer to their home.